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Gout

Gout is a type of arthritis. It results from an excess of Uric Acid (the waste product formed from the breakdown of food and protein) in the blood, which if present long enough, can form into needle-like crystals which can inflame your joints and cause severe pain and swelling. This accumulation of uric acid typically occurs when the body has difficulty processing certain protein substances called Purines that are found naturally in our diets. Your diet plays an important role in both causing gout and in reducing the likelihood of suffering further painful attacks.

Foods Highest in Uric Acid (AVOID THESE):

- Anchovies
- Sardines
- Mackerel
- Sweetbreads (veal, lamb, pork)
- Kidney
- Brain
- Liver
- Scallops
- Meat Extracts (consommé, Oxo)
- Mussels
- Goose
- Herring
- Fish Roe (caviar)
- Yeast containing foods/drinks (BEER/Marmite)
- Wine
- Gravies
- Heart
- Game (rabbit, venison, pheasant)

Foods High in Purines (LIMIT These – No more than 1 serving a day):

- Eel
- Peas
- Cauliflower
- Lentils
- Beans
- Asparagus
- Mushrooms
- Other shellfish (crab, shrimp)
- Whole Grain Cereal
- Whetgerm & Bran
- Trout
- Poultry (chicken, duck, turkey)

Foods Lowest in Purines (GOOD to Eat – in Moderation):

- Milk
- Nuts
- Eggs
- Cheese
- Chocolate
- Ice Cream
- Pasta/Noodles
- Cake
- Refined Cereals
- Vegetables (except noted above)
- Spices/Condiments (salt/vinegar)
- Butter/Margarine
- Biscuits

SYMPTOMS

Gout usually starts with a sudden onset of intense pain in 1 or more joints, usually the big toe joint of the foot. The pain is accompanied by redness, swelling, and warmth over the joint. Other common sites are the instep of the foot, the ankle, or the knee. When the foot is involved, wearing shoes is difficult and painful, as are attempts to stand on the foot.

DIAGNOSIS

The diagnosis is based on a personal and family history (gout can be hereditary), as well as clinical examination of the affected area. Blood tests are often performed to determine uric acid levels. Sometimes, the joint fluid is examined to look for uric acid crystals. X-Rays also may be performed to examine the bones/joints to rule out abnormal changes associated with gout.

TREATMENT

The treatment of gout begins with making the proper diagnosis. Oral anti-inflammatories are most often used to manage the acute attack. While over the counter drugs may reduce symptoms, they are rarely strong enough to treat the acute pain, swelling or inflammation. Prescription anti-inflammatories may help as well as steroid injections to reduce pain and swelling. If the gout attack is in the toe, it will help to elevate the foot, avoid standing or walking, and wear a loose slipper until examined by a podiatrist. It is important that your medical doctor establish which of the two primary causes (producing too much uric acid or not eliminating it properly) is involved in order to treat the gout long term. If gout attacks continue despite medical treatment, if there are excessive deposits of gouty crystals within a joint, or if arthritis causes continual discomfort, surgical treatment may be necessary to remove the crystals (tophi) and repair the joint.

Important Questions


Can losing weight help my gout?

If you are overweight, gradual loss of weight will help you reduce the level of uric acid in your blood and reduce the stress on weight-bearing joints (hips, knees, ankle, feet). However, it is important to avoid any type of crash dieting, as going without food fro long periods and rapid loss of weight can increase urica cid levels and trigger painful gout attacks. A combination of balanced healthy eating and regular physical activity is the best way to lose weight safely and maintain your weight at an optimum.

Are there any foods which are good for gout?

Scientific studies have confirmed the long-held belief that the consumption of cherries/Cherry juice can be beneficial.

Can I drink alcohol?

Drinking alcohol can increase your risk of developing gout and can bring on a sudden attack if you are already a gout sufferer. Alcohol can raise the level of uric acid in the blood in a number of ways and so trigger a gout attack. Many beers contain large quantities of purines from the fermenting process and alcohol stimulates the production of uric acid by the liver. More importantly, alcohol is converted in the body to lactic acid which interferes with the removal of uric acid from the body by the kidneys.

Should I drink lots of water?

Yes, drinking fluids reduces the likelihood of crystals forming in the kidneys. As a general rule, drinking 8-10 glasses of water a day is recommended.